It seems the only people that are really concerned with mid level expansion are medical students and medical school graduates.
Oh, so the future physicians are the only people concerned with having their careers, wellbeing, and futures diluted, tarnished, and taken away? Weird, you think they would be the LAST people to give a damn.
And even among this population it isn't nearly as pervasive as you may believe. If you talk to an Ob/Gyn from any country (most of the developed world) that uses midwives for most child births, you will find most of them are highly supportive of these midlevels.
My comments refer to the good old, US of A ... frankly, I'm not overtly concerned with how physicians in other countries view midlevels (nor do I think many of my future colleagues are either). Furthermore, OB is a perfect example of why my argument is absurdly persuasive. For years, mid-wives have delivered non-COMPLEX births, and everything has been fine. They work with physicians ... no big deal. Right? Isn't this great for the OB/GYN to be able to focus on more complicated cases? Well, let's fastforward ... the mid-wives were able to use their militant lobbying group to get their reimbursement rates up to that of OB levels (as far as insurance companies are concerned ... OB/GYN - a physician with 4 years of medical school and 4 years of extensive residency training = mid-wife when it comes to vaginal deliveries.
Next, they now want to practice independently and work without a physicians license. Look at some of the news segments on it ... it's astonishing. These same people who seem to only want to fill gaps in rural areas now want full reimbursement rates and independent practice. Hmm ... doesn't seem to fit the original mantra. Doesn't seem to increase rural access (recently read an article about mid-wives pushing for independent practice in New York). Doesn't seem like they want to work within part of a team. Doesn't sound like the physicians are the ones clamoring for this. Sounds to me like these people see a back door into getting what they feel like they 'deserve' (because those fat cat OBs working 80 hours a week while 200k in debt need to be knocked down a peg), and they'll use a fake platform/stance to get it.
Even more interesting if you look at the statistics in terms of child birth safety in these countries it is easy to see that midlevels don't increase the risk of child birth for both the mother and the baby.
1. Proof
2. We're still talking about the US here
3. Mid-wives are used in simple, non-emergent, basic births. People also deliver babies at home in freaking bathtubs. Should we advocate that as well? What happens when the **** hits the fan and something goes wrong? Will these midlevels fall back on their surgical training and 17,000 hours spent in residency to assess and solve the problem? Doubt it. If you want to tell me taking a physician out of the birthing equation doesn't increase risks ... you're missing something.
The argument that allowing mid levels more freedom to practice if they demonstrate the aptitude and skills to do so will drag our health care system down to third world levels is both unsubstantiated and in the example of this thread - immoral. While the Lexus standard of health care may seem appealing you have yet to put forth any objective arguments as to why allowing poor people the ability to get basic health care that is not subsidized by the government will be a detriment to anyones well being besides your own
When did I make this argument. I don't think I've ever used the term 'third world,' nor any of the points you put forth. My biggest issues have always been patient confusion/misconception, patient safety (which has yet to be proven by any REAL studies - not one that assess simple births, look at outcomes of treating colds and referring to real doctors six months out, or ones that are funded, conducted by, and published by the ANA), and the fact that people are trying to practice medicine without going to medical school while simultaneously vilifying physicians (yet, who gets called when **** hits the fan?).
However, since these individuals want to get paid the same as physicians, they will actually do nothing to help the budgetary issues associated with health care, while also lowering the standard of care all around.
Furthermore, if you believe diluting the quality of care on the basis that certain individuals claim they want to practice in certain areas (with no guarantees that they will do any of this), then we simply disagree. Finally, I have absolutely no qualms stating that the wellbeing of my loved ones who will/do depend on my future income is something that is important and I will protect. Despite what many believe, a. doctors are not a bunch of money grubbing ****** who want to keep midlevels down so they can profit, b. physicians aren't civil servants who should put the wellbeing of EVERYONE else above their own friends and family. The fact that this ideal coincides with keeping patients safe and well informed only makes it more valuable.
